Gastroesophageal Reflux Disease Presenting With Atypical Symptoms In Children- Challenges Of Diagnosis In Sub-Saharan Africa: Two Case Reports

Abstract

Gastroesophageal reflux disease (GERD) is the involuntary retrograde movement of gastric contents across the lower oesophageal sphincter (LES) into the oesophagus which is associated with inconvenient symptoms or complications. It is prevalent all over the world but more has been reported in developed countries than in developing countries. This is a report of two cases of GERD in children involving a preterm neonate and an adolescent who presented to the University of Calabar Teaching Hospital with non-specific symptoms. The preterm neonate had repeated apnoea and failure to thrive while the adolescent presented with non-cardiac chest pain and abdominal pain. With review by the Paediatric Gastroenterologist, diagnosis of GERD was made and treatment commenced. Both patients showed significant improvement in their symptoms; the preterm gained weight and the apnoea stopped, while the adolescent no longer had the chest pain and abdominal pain. These two cases show that there is the need for a high index of suspicion among Paediatricians who see children with non- specific symptoms such as non-cardiac chest pain, failure to thrive and apnoea in the newborn and to refer them to the Paediatric gastroenterologists timely for proper evaluation and treatment.